No clear relationship between circadian rhythm and cerebral perfusion parameters in pediatric and early adult populations

• Published in: Journal of the neurological sciences 2025-01, Vol.468, p.123351-123351, Article 123351
• Main Authors: Lun, Ronda, Sreekrishnan, Anirudh, Lee, Sarah, Albers, Gregory W
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cerebrovascular Circulation - physiology; Child; Child, Preschool; Circadian Rhythm - physiology; Computed tomography perfusion; Female; Humans; Ischemic stroke; Male; Neuroimaging; Neurology; Pediatric; Perfusion; Retrospective Studies; Stroke; Tomography, X-Ray Computed; Young Adult; Young adults
• ISSN: 0022-510X; 1878-5883; 1878-5883
• DOI: 10.1016/j.jns.2024.123351

AbstractBackgroundRecent literature suggests circadian rhythm influences cerebral perfusion parameters in adults experiencing an acute large vessel occlusion, but this has never been investigated in the pediatric and young adult populations. MethodsWe queried the United States RAPID Insights database (10/05/2018–09/29/2023) for unique patients between 2 and 25 years with computed tomography perfusion (CTP). Included scans had a minimum ischemic core volume (rCBF 0 cc and a Tmax volume of >0 cc. Intracerebral hemorrhage cases were excluded. Anterior circulation large vessel occlusion cases were segregated and reported separately. Imaging time was subdivided into three epochs: Night (23:00 h-06:59 h), Day (07:00 h-14:59 h), and Evening (15:00 h-22:59 h). Age was analyzed by pre-defined strata: 2–5, 6–11, 12–18, and 19–25 years. Perfusion parameters were stratified by age and time epochs. We used non-parametric testing for variables with non-normal distributions. ResultsWe included 2415 CTP scans, with 307 identified as LVO. There were 637 patients 18 or younger, with 85 LVOs. In the overall cohort, LVOs had higher penumbral volumes (75.0 cc [25.0–156.0] vs 26.0 cc [8.0–78.0], p